Author(s)

Abhishesh Shakya^1*, Ratnamani Gajurel¹, Chandramani Poudel¹, Anish Baniya¹, Ravi Sahi²

¹Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC), Institute of Medicine, TUTH, Kathmandu, Nepal.
²Department of Cardiology, Shahid Gangalal National Heart Centre, Bansbari, Nepal.

Introduction: In comparison to anterior wall myocardial infarction, inferior wall myocardial infarction is generally regarded as a low risk event. The aim of this study was to evaluate the prognostic impact of right ventricular (RV) myocardial involvement in patients with inferior wall myocardial infarction (IWMI). Methods: This is an observational study of 82 consecutive IWMI patients admitted and treated in Manmohan Cardiothoracic, Vascular and Transplant Center (MCVTC) from May 15 2018 to June 15 2019. The clinical characteristics, risk factors profile, electrocardiographic, echocardiographic, including RV function and angiographic characteristics, complications and in-hospital deaths were analyzed. Results: The mean age of patients presenting with IMWI was 64.8 ± 13.8 years with predominance of male (67%). Right ventricular myocardial infarction was present in 34.1% of patient with RV dysfunction in 25.6% patients. Mean Tricuspid Annular Plane Systolic Excursion (TAPSE), RV tricuspid annulus (S') and RV Fractional area change (FAC) in patients with RV dysfunction vs patients without RV dysfunction were 12.2 ± 3.3 mm vs 22.5 ± 3.5 mm (p < 0.001), 7.54 ± 0.91 cm/s vs. 12.79 ± 2.16 cm/s respectively (p < 0.001) and 29.7 ± 2.58 mm² vs 39.46 ± 2.85 mm² respectively (p < 0.001). The in-hospital mortality rate was 8.5%. Conclusion: In inferior wall myocardial infarction, RV involvement with RV dysfunction is an independent risk factor for in-hospital mortality along with advanced age, complete atrioventricular block, higher Killip class, delayed hospital presentation, left ventricular ejection fraction < 40% and angiographic evidence of triple vessel disease.

Anterior Wall Myocardial Infarction, Inferior Wall Myocardial Infarction, Right Ventricular Infarction, Prognosis

Shakya, A. , Gajurel, R. , Poudel, C. , Baniya, A. and Sahi, R. (2023) Impact of Right Ventricular Dysfunction in Morbidity and Mortality in Patients with Inferior Wall Myocardial Infarction Presenting to a Tertiary Care Center of Nepal. World Journal of Cardiovascular Diseases, 13, 780-794. doi: 10.4236/wjcd.2023.1311067.